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Introduction: Stress is the response of body to any change. The end stage of renal disease and the process of haemodialysis treatment are long-term stressors that alter patients’ well-being and everyday lifestyle. The aim of this study was to find out the prevalence of moderate stress levels among patients undergoing hemodialysis in a tertiary care centre. Methods: A descriptive cross-sectional study was conducted among patients undergoing hemodialysis from 1 October 2021 to 30 September 2022. Ethical clearance from the Institutional Review Committee. Patients undergoing maintenance haemodialysis for at least 3 months were included in the study. Convenience sampling method was used. The point estimate was calculated at a 95% Confidence Interval. Results: Among 118 patients, 82 (69.49%) (61.18-77.80, 95% Confidence Interval) had moderate stress levels, out of which 51 (62.20%) were male and 31 (37.80%) were female. Conclusions: The prevalence of moderate stess level was found to be higher than other studies done in similar settings.

The purpose of this review was to analyse the literature regarding the correlation between the level of tryptamine, aryl hydrocarbon receptor (AHR) signalling pathway activation, and monoamine oxidase (MAO)-A and MAO-B activity in health and conditions such as neurodegenerative, neurodevelopmental, and psychiatric disorders. Tryptamine is generated through the decarboxylation of tryptophan by aromatic amino acid decarboxylase (AADC) in the central nervous system (CNS), peripheral nervous system (PNS), endocrine system, and gut bacteria. Organ-specific metabolism of tryptamine, which is mediated by different MAO isoforms, causes this trace amine to have different pharmacokinetics between the brain and periphery. Reactive oxygen species (ROS) generated by MAO can influence miRNA-CYP enzyme regulatory network and affect mitochondrial function. Tryptamine regulates AHR function by acting as an endogenous ligand for AHR, initiating AHR activation and inhibiting the expression of the CYP1A1 and CYP1A2 genes. The dysregulation of AHR signalling, triggered by endogenous tryptamine binding, can disrupt the regulation of prolactin levels. Depending on the tryptamine concentration and context, tryptamine can be beneficial or harmful. By acting as an agonist of inhibitory serotonin receptors and trace-amine associated receptor 1 (TAAR1) and an antagonist of excitatory serotonin receptors, it can engage in diverse physiological interactions with serotonin. Increased tryptamine production is observed under hypoxic conditions and is associated with hypoxia-inducible factor 1α (HIF-1α) activation, leading to AHR activation. Dysregulation of the association between tryptamine levels, AHR signalling pathway activation, and MAO activity are observed in Alzheimer's disease (AD), Parkinson's Disease (PD), Autism Spectrum Disorder (ASD) and schizophrenia., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Coronary artery disease (CAD) is one of the severe diseases that may cause significant moral and financial burden on society today. There are many studies in the literature on whether psychiatric disorders may cause CAD or an increase in prevalence after CAD. Although many studies have emphasized the importance of early diagnosis and treatment of depression in CAD patients, clinicians do not attach much attention to depression in daily practice. Several scales have been developed that are comfortable to use to describe anxiety and depression in CAD patients. High depression and anxiety scores predicted by psychological symptom scales following CAD treatment are closely related to treatment success and prognosis of the CAD. We believe that patients with CAD should be followed carefully for the diagnosis of depression and anxiety disorders; since the treatment of them may improve the prognosis of CAD.

Aim and Background: Psychiatric disorders are gaining top rank in the burden of disease. Undoubtedly, knowing their prevalence in children and adolescents can help prevent and control these problems and save money. Therefore, the purpose of this study was to investigate the prevalence of psychiatric disorders in children and adolescents in Isfahan. Methods and Materials: According to the nature of the research, the research method is a fundamental type that was performed on 1010 children and adolescents in Isfahan province in 2017 that were randomly selected using multistage cluster sampling. Clinical psychologists are trained to conduct research refer to the selected children's homes and using the Persian version of the semi-structured diagnostic interview for Mental Disorders and Schizophrenia for children and adolescents, Current Detection and Lifespan (K-SADS-PL). In addition, demographic data (gender, age, education, parental education, and economic status) were also collected. After collecting the data, the data were analyzed by SPSS software using frequency indices and frequency. Findings: According to the findings, the prevalence of psychiatric disorders in children and adolescents in Isfahan province is 14.8% and the prevalence of these disorders in boys is higher than in girls. Also, according to the results, the prevalence of these disorders in the age range of 10-14 years was more than other ages. Psychiatric disorders in children and adolescents in the city were more than children and adolescents in the village. Conclusions: According to the results, the prevalence of psychiatric disorders in Isfahan province is in the middle range compared to other studies carried out in other researches carried out inside and outside the country. However, the need for mental health policies in childhood and adolescence is suggested to reduce the burden of damage in the future and provide solutions to the proble m.

Objective: The objective of this retrospective study was to investigate the peripheral immunological markers using leucocyte count, the neutrophil to lymphocyte ratio (NLR), the platelet to lymphocyte ratio (PLR), and the monocyte to lymphocyte ratio (MLR) in patients with aggressive behavior, during and after seclusion., Methods: Ninety-nine inpatients were included in this retrospective study. Leucocyte count was measured, and NLR, PLR and MLR were calculated and compared between a group of patients who required seclusion and a group who did not. A multivariate analysis was performed using binary logistic regression, including confounding factors such as age, gender, medication, BMI, smoking status and diagnosis., Results: We found the lowest levels of lymphocytes (P=0.01) and basophils (P<0.01) and the highest NLR (P=0.02) and MLR (P=0.04) in the seclusion group. We also found a restoration of these parameters after the end of the seclusion period. Furthermore, we found a positive correlation between the PANSS negative subscore, and PLR (P=0.05), or MLR (P=0.03) after seclusion, and between the MLR variation across the seclusion period and the PANSS general subscore after the end of seclusion (P=0.04)., Conclusion: This study shows that NLR and MPR are higher in patients with aggressive symptoms and/or agitation who require seclusion. These immunological markers could be considered as state markers., (Copyright © 2023 L'Encéphale, Paris. Published by Elsevier Masson SAS. All rights reserved.)

Sleep disorders and mental health conditions often coexist, with a complex and bidirectional relationship between the two. This research aims to examine the impact of sleep disturbances on mental health outcomes and explore the efficacy of sleep-focused interventions in managing psychiatric conditions. A comprehensive review of the literature will be conducted to analyze existing research studies, clinical trials, and meta-analyses. The results will shed light on the relationship between sleep disturbances and mental health by outlining the mechanisms underlying it. In addition, this study will assess how well pharmaceutical therapies and other sleep-focused interventions, such as cognitive-behavioral therapy for insomnia, work to improve the mental health of people with psychiatric disorders. [ABSTRACT FROM AUTHOR]

Botulinum neurotoxin has remarkably transitioned from a food safety hazard and biological warfare to an effective therapeutic drug. Currently, botulinum neurotoxins have seven serotypes (BoNT/A-G) in the form of protein complexes produced by Clostridium , a gram-positive and sporeforming bacteria. The conversion of toxins into useful drug substances of choice using the biotechnological process is tremendously increasing. Recent studies have shown that Botulinum neurotoxin-A (BoNT/A) has different biological activities and potencies in experimental and clinical conditions. They also indicate that the manufacturing process influences the potency and efficacy of BoNT/A drugs. Thus, this review focuses on the following criteria: detailed Fed-batch operation that includes the upstream and downstream processing of BoNT/A, the underlying mechanism behind the neurotoxic effect, and commercially available FDA-approved BoNT/A products and their therapeutic uses. Still, some research gaps exist in the mechanism for the treatment of psychiatric disorders., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Psychiatric disorders are complex, multifactorial illnesses. It is challenging for us to understand the underlying mechanism of psychiatric disorders. In recent years, the morbidity of psychiatric disorders has increased yearly, causing huge economic losses to the society. Although some progress, such as psychotherapy drugs and electroconvulsive therapy, has been made in the treatment of psychiatric disorders, including depression, anxiety, bipolar disorder, obsessive-compulsive and autism spectrum disorders, antidepressants and psychotropic drugs have the characteristics of negative effects and high rate of relapse. Therefore, researchers continue to seek suitable interventions. cAMP response element binding protein (CREB) belongs to a protein family and is widely distributed in the majority of brain cells that function as a transcription factor. It has been demonstrated that CREB plays an important role in neurogenesis, synaptic plasticity, and neuronal growth. This review provides a 10-year update of the 2013 systematic review on the multidimensional roles of CREB-mediated transcriptional signaling in psychiatric disorders. We also summarize the classification of psychiatric disorders and elucidate the involvement of CREB and related downstream signalling pathways in psychiatric disorders. Importantly, we analyse the CREB-related signal pathways involving antidepressants and antipsychotics to relieve the pathological process of psychiatric disorders. This review emphasizes that CREB signalling may have a vast potential to treat psychiatric disorders like depression. Furthermore, it would be helpful for the development of potential medicine to make up for the imperfection of current antidepressants and antipsychotics.

Background: The most common psychiatric disorder in childhood is Attention-deficit/hyperactivity disorder (ADHD). Researchers have studied the effects of micronutrients on ADHD in recent years, but vitamin D (vit D) deficiency has received less attention. In this study, serum vit D levels were compared between healthy and ADHD children., Methods: This case-control study was carried out, in 2020, on 6-to-12-years-old children. There were 45 children with ADHD in the case group and 45 healthy children in the control group. Intravenous blood samples were taken from each child to measure serum vitamin D levels. A p-value < 0.05 was considered as significant., Results: Mean serum vit D levels in children with ADHD (17.34±8.37 ng / ml) were significantly lower than those in the control group (23.02±10.97 ng / ml) (P= 0.007). There were no significant differences in mean serum levels of vit D due to ADHD subtypes. Mean serum vit D levels were not significantly associated with the gender of children with ADHD. There was an inverse correlation between vit D levels and the severity of ADHD, but it was not statistically significant., Conclusion: The present study showed that children with ADHD had significantly lower serum vit D levels than healthy controls., Competing Interests: None declared by the authors.

Objective: Neuropsychiatric disorders are one of the major contributors to the global burden of disease and disability. Issue of disability in psychiatric disorders has been studied across multiple studies in India. However, there are no reports on the profile and nature of disability among those seeking disability certificates. The current study aims at understanding the socio-clinical profile of patients seeking disability certificate in a tertiary care hospital in India. Methods: The study was carried out in the Department of Psychiatry of a tertiary care multispecialty teaching hospital. A chart review of the records of the patients referred for disability evaluation over a one year period was conducted. The disability was assessed using IDEAS. In between group comparisons were carried out for male and female subjects for different sociodemographic variables, IDEAS total score and individuals item score using independent sample t test (parametric test) and Mann Whitney-U test (non parametric test). Additionally, Spearman’s rank order correlation was calculated to establish the level of correlation between total IDEAS score and score on individual items of the scale. Results: The subjects were diagnosed to have been suffering from mental retardation 107 (61.8� schizophrenia 54 (31.2� dementia 5 (2.9� bipolar affective disorder 4 (2.3�20and obsessive compulsive disorder 3 (1.7�20as per ICD-10. Male and female subjects differed significantly on the global IDEAS score. The total score was significantly higher for male subjects compared to female subjects. The difference was statistically significant for

Objective: to study the frequency of anaemia in various chronic psychiatric disorders in an adult population. Study Design: Cross-sectional study. Place and study duration: Creek General Hospital, Karachi Pakistan, from Feb to May 2021. Methodology: Two hundred and six patients were enrolled in the outpatient clinics after informed consent. Adult patients of 18 to 50 years who were clinically diagnosed with a psychiatric disorder by a certified psychiatrist and had no organicity were included in the study. Anaemia was defined as haemoglobin less than 13 gm/dl for males and less than 12 gm/dl in females. The severity of anaemia was classified into mild, moderate and severe according to the haemoglobin range by WHO criteria. The type of anaemia was categorized into microcytic, normocytic and macrocytic according to the value of mean corpuscle volume. Results: The overall frequency of anaemia in patients suffering from psychiatric disorders was 126 (61.2%) out of 206 persons. Among the anaemic, 20 (58.8%) had schizophrenia; depression was present in 35 (63.6%), generalized anxiety disorder in 39 (57.4%), somatoform disorders in 20 (62.5%) and 12 (70.6%) in bipolar subjects. Among those who were anaemic, a normocytic value was found in 28 (13.6%) adults, microcytic in 95 (46.0%) patients and macrocytic in 4 (1.9%). The severity of anaemia among anaemic was highest in the mild group. Sixty-nine males (53.6%) and 89 females (65%) were anaemic. (p=0.078). Anaemia was found highest in the 40-50 years age group. Conclusion: Anaemia was frequently found in adults suffering from chronic psychiatric disorders. [ABSTRACT FROM AUTHOR]

Assessment of reactive oxygen species (ROS) is highly important in neurodegenerative disorders and neuroleptic treatment. However, conflicting results have been reported, which may arise from methodological difficulties. Obstructive sleep apnea (OSA) syndrome with episodic hypoxia-reoxygenation is proposed as a human model for the investigation of ROS measurements. Despite a broad analytical approach comprising lipid peroxidation and amino acid oxidation products, oxidative DNA damage, and activity of the antioxidant defense, only plasma malondialdehyde (MDA) and urinary o,o′-dityrosine seemed to be appropriate, robust biomarkers of oxidative stress, which are also simple enough for routine clinical use. MDA concentrations correlated with a duration of nocturnal desaturation below 85% (r = 0.77, p<0.0005), and o,o′-dityrosine levels decreased after therapy (p<0.05) as a function of baseline concentrations (r = −0.61, p<0.05). Gender effects in ROS generation also have to be considered. At present, we recommend the application of several oxidative stress measurements at different time points, preferably involving plasma MDA and urinary o,o′-dityrosine. [ABSTRACT FROM AUTHOR]

The purpose of this study was to identify what patient and physician factors influence resident satisfaction with patient encounters in a continuity clinic setting. Resident satisfaction was assessed from postencounter questionnaires completed by 68 internal medicine residents regarding 979 patient encounters. We found that residents were more satisfied with patients diagnosed with general medical problems than with patients diagnosed with pain and psychiatric disorders. First-year residents were less satisfied with patients diagnosed with pain and psychiatric disorders than second- and third-year residents. However, this dissatisfaction with seeing patients with pain or psychiatric disorders lessened as continuity of care was enhanced. J GEN INTERN MED 2004;19:456 – 459. [ABSTRACT FROM AUTHOR]

Cluster analysis was used to identify subgroups of youths with past-year substance and/or psychiatric disorders (N = 110, mean age 19.0 years). Data for this study came from a community-based, prospective longitudinal investigation of speech/language (S/L) impaired children and matched controls who participated in extensive diagnostic and psychosocial assessments at entry into the study at 5 years of age and again at follow-up. Clustering variables were based on five DSM diagnostic categories assessed at age 19with the University of Michigan Composite International Diagnostic Interview. Using Ward's method, the five binary variables were entered into a hierarchical cluster analysis. An iterative clustering method (K-means) was then used to refine the Ward solution. Finally, a series of analyses of variance (ANOVAs) were run to analyze group differences between clusters on measures of Global Assessment of Functioning (GAF), criminal involvement, anxiety and depressive symptomatology, and frequency of drug use and heavy drinking. The analysis yielded eight replicable cluster groups, which were labeled as follows: (a) anxious (20.9%); (b) anxious drinkers (5.5%); (c) depressed (16.4%); (d) depressed drug abusers (10%); (e) antisocial (16.4%); (f) antisocial drinkers (10%); (g) drug abusers (8.2%); (h) problem drinkers (12.7%). These groups were differentiated by external criteria, thus supporting the validity of our cluster solution. Cluster membership was associated with a history of S/L impairment: A large proportion of the depressed drug abusers and the antisocial cluster group had S/L impairment that was identified at age 5. Clarification of the developmental progress of the youths in these cluster groups can inform our approach to early intervention and treatment. [ABSTRACT FROM AUTHOR]

Schizophrenia is a serious psychiatric disorder leading to cognitive impairment and has higher rates of morbidity and mortality. There is a need to understand the mechanisms underlying the onset and progression of the disease as the clinical presentation may vary in patients and inadequate knowledge of neurochemical alterations can lead to decreased efficacy in treatment which makes it necessary to identify new potent biomarkers. Identification of biomarkers in schizophrenia offers significant benefits to the well-being of patients, including better prognosis, diagnosis, detection, screening, enhancement in treatment efficacy, prevention of relapse, and better clinical results. Incorporation of advanced technological techniques is necessary to provide an approach for the diagnosis and treatment of psychiatric disorders and to permit specific therapeutic interventions. This review highlights the particulars about the current use and application of various biomarkers such as proteomics, miRNAs, language techniques, antibodies, blood biomarkers, gut microbiota, such as analysis, neuroimaging techniques, and inflammatory biomarkers in effective prognosis, detection, and treatment of schizophrenia and which would contribute as an additional tool for a psychiatrist in cases where an appropriate diagnosis is lacking clarity., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Abstract Background Topiramate is a new antiepileptic drug, originally designed as an oral hypoglycaemic subsequently approved as anticonvulsant. It has increasingly been used in the treatment of numerous psychiatric conditions and it has also been associated with weight loss potentially relevant in reversing weight gain induced by psychotropic medications. This article reviews pharmacokinetic and pharmacodynamic profile of topiramate, its biological putative role in treating psychiatric disorders and its relevance in clinical practice. Methods A comprehensive search from a range of databases was conducted and papers addressing the topic were selected. Results Thirty-two published reports met criteria for inclusion, 4 controlled and 28 uncontrolled studies. Five unpublished controlled studies were also identified in the treatment of acute mania. Conclusions Topiramate lacks efficacy in the treatment of acute mania. Increasing evidence, based on controlled studies, supports the use of topiramate in binge eating disorders, bulimia nervosa, alcohol dependence and possibly in bipolar disorders in depressive phase. In the treatment of rapid cycling bipolar disorders, as adjunctive treatment in refractory bipolar disorder in adults and children, schizophrenia, posttraumatic stress disorder, unipolar depression, emotionally unstable personality disorder and Gilles de la Tourette's syndrome the evidence is entirely based on open label studies, case reports and case series. Regarding weight loss, findings are encouraging and have potential implications in reversing increased body weight, normalisation of glycemic control and blood pressure. Topiramate was generally well tolerated and serious adverse events were rare.

Background: Genetic polymorphisms of drug metabolizing enzymes can substantially modify the pharmacokinetics of a drug and eventually its efficacy or toxicity; however, inferring a patient's drug metabolizing capacity merely from his or her genotype can lead to false prediction. Non-genetic host factors (age, sex, disease states) and environmental factors (nutrition, comedication) can transiently alter the enzyme expression and activities resulting in genotypephenotype mismatch. Although valproic acid is a well-tolerated anticonvulsant, pediatric patients are particularly vulnerable to valproate injury that can be partly attributed to the age-related differences in metabolic pathways., Methods: CYP2C9 mediated oxidation of valproate, which is the minor metabolic pathway in adults, appears to become the principal route in children. Genetic and non-genetic variations in CYP2C9 activity can result in significant inter- and intra-individual differences in valproate pharmacokinetics and valproate induced adverse reactions., Results: The loss-of-function alleles, CYP2C9*2 or CYP2C9*3, display significant reduction in valproate metabolism in children; furthermore, low CYP2C9 expression in patients with CYP2C9*1/*1 genotype also leads to a decrease in valproate metabolizing capacity. Due to phenoconversion, the homozygous wild genotype, expected to be translated to CYP2C9 enzyme with normal activity, is transiently switched into poor (or extensive) metabolizer phenotype., Conclusion: Novel strategy for valproate therapy adjusted to CYP2C9-status (CYP2C9 genotype and CYP2C9 expression) is strongly recommended in childhood. The early knowledge of pediatric patients' CYP2C9-status facilitates the optimization of valproate dosing which contributes to the avoidance of misdosing induced adverse reactions, such as abnormal blood levels of ammonia and alkaline phosphatase, and improves the safety of children's anticonvulsant therapy., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.)

Psychotic disorders are recognized as severe mental disorders that rigorously affect patient's personality, critical thinking, and perceptional ability. High prevalence, global dissemination and limitations of conventional pharmacological approaches compel a significant burden to the patient, medical professionals and the healthcare system. To date, numerous orally administered therapies are available for the management of depressive disorders, schizophrenia, anxiety, bipolar disorders and autism spectrum problems. However, poor water solubility, erratic oral absorption, extensive first-pass metabolism, low oral bioavailability and short half-lives are the major factors which limit the pharmaceutical significance and therapeutic feasibility of these agents. In recent decades, nanotechnology-based delivery systems have gained remarkable attention of the researchers to mitigate the pharmaceutical issues related to the antipsychotic therapies and to optimize their oral drug delivery, therapeutic outcomes, and patient compliance. Therefore, the present review was aimed to summarize the available in vitro and in vivo evidences signifying the pharmaceutical importance of the advanced delivery systems in improving the aqueous solubility, transmembrane permeability, oral bioavailability and therapeutic outcome of the antipsychotic agents., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.)

Background and Objective: Anorexia Nervosa (AN), Bulimia Nervosa (BN) and their variants are characterized by persistent alteration of eating behaviour, such as restricted intake or bingeing and purging, as well as excessive concerns about body shape and body weight. Purging behaviour may include self induced vomiting and/or abuse of laxatives, diuretics and physical hyperactivity. Unlike other psychiatric disorders, patients suffering from AN and BN have a high prevalence of many different medical complications, through the sequelae of undernutrition and purging, often with a serious impairment of health status and quality of life. This article describes the main diagnostic and clinical aspects of medical complications in AN and BN., Results: The medical complications of ED are extremely variable and can occur with only modest biological and physical damage up to extremely serious and life-threatening conditions; the mortality rate of young subjects with AN is 4 - 11% with a risk of death about 12 times higher than that of subjects of the same age of the general population. The management of the medical-internship aspects of AN and BN is rightly placed within complex and articulated programs of interdisciplinary treatment with different levels of intensity of care (outpatient, semi-residential/residential, hospital in cases of emergency/medical and/or psychiatric emergency)., Conclusion: the results of the investigations carried out, describe the functions of the various organs and apparatuses and the alterations detected, the possible complications and physiological adaptations to malnutrition., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.)